Posted by: Laurie ®
10/18/2004, 17:43:29
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While I could write a long response to this question, I'll keep it somewhat brief.What I've heard regarding "muscle tension dysphonia" (the term itself, in my opinion, being a rather non-descript way of describing a voice problem) is that it can result from over-compensating for some underlying vocal pathology. i.e., if someone has a nodule or polyp and starts compensating to talk around it, that might be called muscle tension dysphonia. it can generally be helped (assuming the underlying problem is addressed) with speech therapy. "muscle tension dysphonia" will generally not respond to botox. people who are nervous may have a "nervous sounding" voice upon public speaking, in social situations, whatever, but that's hardly what I'd call a voice disorder. I've never heard of any legitimate case of "psychogenic dysphonia," just as I've never heard of any legitimate case of psychogenic parkinson's disease, psychogenic MS, etc. etc. In any case, neither have much to do with laryngeal dystonia. Laurie
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Posted by: Lynne Martinez ®
10/18/2004, 18:10:21
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Briefly --"Muscle Tension Dysphonia" is a functional dysphonia arising from improper use of the larynx and surrounding muscles (neck/vocal, etc.). MTD causes tension in the neck/laryngeal area which results in voice strain or other vocal problems. Often reponds to speech/vocal therapy. "Psychogenic Dysphonia" is a vocal anomoly, with various names and diagnoses, with a causative component of mental/emotional/psychological origins. The term "Dysphonia" means, in the simplest language - "voice doesn't work properly." It is a generic term describing numerous vocal irregularities. On the other hand, "Spasmodic Dysphonia" (AKA Laryngeal Dystonia) is a neurological disorder, as opposed to a functional or psychogenic disorder. SD is a "Movement Disorder" of the vocal cords, originating in the brain, where erroneous signals are communicated to the vocal cords (from the brain) specifically. Neurological, in contrast to "functional" or "psychogenic." At times, some of these various voice disorders intersect and change, as our bodies change over time. Cases are unique, based on the individual. The larynx and the brain are both very complex organs. The larynx is considered the most complex organ in the human body, based on its size. Hope this helps. --Lynne (AD/SD; RLN surgery; PVFM/VCD and other laryngeal things)
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Posted by: David Barton ®
10/18/2004, 19:09:22
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I would add that when the symptoms of SD first come on, they are so inexplicable, and the voice so weird-sounding, that it is understandable that a typical patient feels their voice should be under their control. Because it isn't they tend to feel they are either not speaking correctly (possible MTD - fixable with voice therapy) or that some psychiatric/conversion disorder is making them speak that way.With genuine SD, of course, the SD voice spasms are due to the neurological movement disorder we call 'laryngeal dystonia' and the SD patient is NOT to blame for their voice symptoms, has not abused their voice, and is just as well-balanced and 'normal' (emotionally and intellectually) as people who do not have SD. David Barton (AD/SD, Auckland, New Zealand)
Modified by David Barton at Mon, Oct 18, 2004, 19:10:42
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Posted by: Samietooo ®
10/19/2004, 08:22:05
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Thank you for adding on that explanation, David. As we know from many SD'ers, many people who don't know about this voice disorder, are actually 'blamed' by family members, friends and EVEN doctors!! As you said, we are NOT to blame! Many of us get depressed and frustrated having SD, and possibly need to seek professional help to deal with it, BUT professional help (psychologists/psychiatrists) will not cure SD because it is NOT a psychological disorder!It amazes me how so many doctors don't know about SD and we are STILL having misdiagnosis and people running around from one doctor to another, to date!! Best of luck to all of us and all who have incurable disorders/illnesses!! Carol
(Florida)
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Posted by: Lynne Martinez ®
10/19/2004, 20:21:55
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To add to this conversation (re conversion dysphonias, which are psychogenic, or MTD and SD which aren't)...Some wise SD'er (or dystonia patient) said many years ago (at a symposium or on the BB - to paraphrase): "I didn't get this because I'm crazy but having it can make me crazy." Seems many of us can relate to that, in our own lives. Also, on this subject ("crazy, psychogenic" etc.) it's important to note that if anyone with SD (or anything else for that matter) applies for SSI or SSDI that you will be sent for a psychiatric evaluation. Some take this as an affront, since SD is not a psychogenic vocal disorder. The SSA does this, by standard procedure, to determine if people getting money from the US govt know how to handle it. Some of the people applying for SSI and SSDI are truly nuts and can't handle money and have to have a conservator. Thus, if any SD'er (applying for federal benefits) gets sent to a psychiatrist, it's no big deal and not to be taken personally. Just part of their routine procedure. If my severe atypical case is any example, I got sent to a shrink by the SSA and they acknowledged my vocal/breathing disability. That was it. --Lynne
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